CMI Membership Application - Form - Congregation Mishkan Israel

Personal Information

Member 1

Member 2

Last Name

First Name

Date of Birth

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Date of Birth

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Preferred gender identity

Hebrew Name (if applicable)

Date of B'Mitzvah (if applicable)

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Date of B'Mitzvah (if applicable)

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Date of Confirmation (if applicable)

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Date of Confirmation (if applicable)

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Marital Status

Date of Marriage (if applicable)

Email Address

Employer

Occupation/Title

Mobile Phone

IF Other - How?

Address Information

Residence Street

Apartment #

City

State

Zip Code

Home Phone Number

Billing Address (if different)

Billing Street Address

Apartment #

City

State

Zip Code

Family Information

Children (please complete as it applies to each of your children residing with you)

1st Child

2nd Child

3rd Child

4th Child

Last Name

First Name

Hebrew Name (if applicable)

Birth Date

Click on month, date, year to type in change; or click on arrow at right of box to select from calendar.

Birth Date

Click on month, date, year to type in change; or click on arrow at right of box to select from calendar.

Birth Date

Click on month, date, year to type in change; or click on arrow at right of box to select from calendar.

Birth Date

Click on month, date, year to type in change; or click on arrow at right of box to select from calendar.

Preferred gender identity

Current School Grade

Adult Children (25 years or older) Not Residing With You

1st Child

2nd Child

3rd Child

4th Child

Last Name

First Name

Hebrew Name (if applicable)

Birth Date

Preferred gender identity

Other Person in Household (please indicate name & relationship)

Yahrzeit Information

Yahrzeits are observed and announced at the Shabbat service immediately following the anniversary date of death. The CMI community supports you in remembering your loved one. To add additional names to our yahrzeit registry, please call the synagogue office at (203) 288-3877.

Name of Deceased

Relationship

Member 1 or 2?

Secular Date

Click on month, date, year to type in change; or click on arrow at right of box to select from calendar.

Name of Deceased

Relationship

Member 1 or 2?

Secular Date

Name of Deceased

Relationship

Member 1 or 2?

Secular Date

Name of Deceased

Relationship

Member 1 or 2?

Secular Date

Name of Deceased

Relationship

Member 1 or 2?

Secular Date

Getting involved:

Other - Please list other interests, talents, hobbies

Description of Membership Involvement Opportunities

Financial Commitments

Desired Membership Category
	Family - 35 years old & over	$2,590*
	Single Parent	$1,910
	Single - 35 years old & over	$1,450
	Single - 34 years old & under	$1,120
	Student - 25 years old & under	$200
	Associate-Friend of CMI - Single	$400^
	Associate-Friend of CMI-Family	$800^
	Security Assessment	$160
*Note: Family membership includes 2 adults and all children 25 years of age and under
^Associate - Friend Members who reside outside the Greater New Haven community or who have a full affiliation with another congregation and wish to establish or maintain a connection to CMI. Associate members receive the weekly e-newsletter, our monthly bulletin and may attend adult education classes or other events at CMI member rates. High Holiday tickets are not included in this membership and may be purchased for $180 per person.

Religious School Fees

	PRE K, K ( ages 3 + 5 year old)	$150
	1st & 2nd Grade	$250
	3rd-7th Grades	$500
	CMI High/Confirmation	$180

All financial obligations apply to the fiscal year that begins July 1. Anyone joining the Congregation after the first day of July but prior to Yom Kippur shall be expected to pay the full amount of annual dues. Anyone joining thereafter shall have their dues prorated by quarters.

Membership Commitment and Religious School fees are billed annually. A minimum of one quarter of annual membership commitment or a recurring payments plan should accompany your membership application in order to activate your membership. Subsequent payments can be made annually, quarterly or monthly. Religious School tuition is paid on July 1 or at the time of registration if after July 1.

It is the policy of The Congregation Mishkan Israel to welcome all regardless of financial need. If fees are a concern, please contact executive director Jody Dietch so we can work with you to find a comfortable solution that reflects your individual situation.

I/We promise to pay to Congregation Mishkan Israel the Annual Membership Fees for the category of membership discussed. I/We understand that leaving the congregational membership does not result in abatement of this pledge, unless I/we move out of the area generally served by Congregation Mishkan Israel.

Is there anything that we should be aware of?

Member 1

Typing your name here is the equivalent of your signature. You are agreeing to the above as conditions of membership.

Member 2

Typing your name here is the equivalent of your signature. You are agreeing to the above as conditions of membership.